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i <br /> San Joaquin County Environmental Health Division <br /> Septic Tank and Cesspool Cleaners Report <br /> Company's Name: SRCPumping Co. <br /> Company's Address: 11350 Kiefer Blvd,Sacramento, Ca. 95830 <br /> Report for the Month Of. l <br /> Gallons Where Cleanings <br /> Date Name of Property Owner Location City Pum ed Were Unloaded <br /> '� <br /> ' LI) <br /> J <br /> ZA Z-2 <br /> v <br /> a Ai1v T u <br /> O61 <br /> JA— 17 ZA,t l f Sr?lc1 c <br /> yd, 1033 <br /> Return by the 12th of each month to: <br /> Date Signature of Applicant Environmental Health Division <br /> 304 E. Weber St., 3rd Floor <br /> Stockton, Ca. 95202 <br />